Sitting 3000 miles away from London in Washington DC, I’ve been following the dismissal of Professor David Nutt as the UK government’s senior scientific advisor on the misuse of drugs, with interest.  Not being steeped in British drugs politics, I was only vaguely aware of the tensions between the Advisory Council on the Misuse of Drugs, which Nutt chaired until Friday, and UK policymakers.  So as the story broke, I found it tough to disentangle whether this was a case of a respected scientist demonstrating a blindingly naive understanding of policy, or a government forfeiting science in favor of ideology.  But the more I dig into the situation, the more it seems to highlight a worrying disdain for science and evidence* amongst policy makers.

Nutt’s dismissal will undoubtedly have long-term repercussions on the effectiveness with which UK policies prevent people’s lives being destroyed by drug abuse.  But it also calls into question how science and evidence are used in making policy decisions.  And this is what really worries me – in a science and technology-based society, where information is no longer controlled and constrained by an elite few, playing fast and loose with “evidence” is a politically and socially dangerous game that threatens to marginalize experts and undermine legitimate authority.

David Nutt’s case struck a particular chord with me.  In my day job I work with people who advise on, advocate for and formulate policy.  And I’m constantly surprised at how hard it is to ensure that recommendations and decisions are informed by “evidence,” rather than the evidence being cherry picked and massaged in support of predetermined ideas.  Even in a supposedly science-savvy administration, this is a very real challenge.  For a whole host of reasons, the system is biased towards people who see knowledge as a tradeable and malleable commodity, and who have a startlingly loose attitude toward evidence.  Even well-meaning players in the policy arena sometimes seem to struggle with listening to what the evidence says, rather selectively using it to make a point.

But the grounds for Nutt’s dismissal also struck a more personal chord. Having a son at middle school and a daughter at high school, I have been dismayed at how “evidence” is sometimes misused in the push to prevent children from abusing drugs (both legal and illegal).  My evidence is largely anecdotal, but it seems that in their “drugs education,” there is a tendency for inconvenient facts to be avoided and, on occasion,  information to be “massaged” in the effort to steer the kids toward a safer and healthier lifestyle.

Both of these examples speak to a systemic disdain for evidence – and the science on which it is often built – that results in it being a political tool, rather than a policy foundation.  And this I find truly worrying – whether dealing with drug policy or a number of other issues, we’re in danger of building a foundation-less house of cards that will collapse at the slightest touch if evidence isn’t handled with integrity and respect.

To be very clear here, I am appalled at the horrific damage caused by drug abuse to individuals and society as a whole and, like most people, I see this as a social problem that desperately needs solutions. But I struggle to see how the problem can be solved by ignoring the evidence, and promulgating what can only be described as “un-truths.”  Certainly, policy decisions need to take into account far more than just the current state of knowledge.  But without transparency, honesty, and a foundation of truth, how will people be empowered to make wise and informed decisions?

In an effort to understand whether David Nutt’s dismissal was a product of this culture of evidence-disrespect, or simply down to his political naivety, I actually took the time to read the paper that led to his removal.  It was presented to the Center for Crime and Justice Studies in the UK last week, and can be read in full here.

Given the fuss that it led to, I was expecting an outspoken and ill-considered attack on current drugs policies in the UK.

I couldn’t have been further from the truth.

Nutt’s paper – “Estimating drug harms: a risky business?” – is authoritative, insightful, pertinent, and cognizant of the broader context in which policy decisions are made.  His arguments – and the science and investigations on which they are based – were sound and well-presented.  And I found the conclusions he drew to be reasonable.

It is very clear that Nutt understands the broader social context in which policy decisions are made, and that evidence is just one of a number of factors that need to be addressed.  But he makes it very clear that this evidence should be foundational – and as a consequence, needs to be robust, available, listened to, and not distorted.

I would strongly recommend anyone tempted to weigh into this debate to read Nutt’s paper first, including Home Secretary Alan Johnson.

Especially Alan Johnson!

Perhaps Nutt’s greatest crime is that he sincerely – and altruistically I believe – tried to speak truth to power.  He attempted to provide decision-makers with a sound scientific and evidence-based foundation on which to base policies that would improve people’s lives.  Contrary to my earlier fears, it is clear that he did this with a full understanding of the the broader framework within which policy is made.  His downfall was that he was working with a government that seems to believe in speaking power to truth rather than truth to power – deciding what is right first, then bolstering this up with evidence!

Sadly, this is a model of government that is not sustainable in this day and age – I’m not sure it ever was.  Without a doubt, policy decisions need to be evidence-informed, not evidence-dictated.  But you still need to start with the evidence.  Corrupt this, and you end up harming the people you are trying (supposedly) to help.

Hopefully the rather unfortunate case of David Nutt’s dismissal will shake people up, and lead to renewed attempts to place evidence – and science – at the heart of policy making.

If it doesn’t, I’m afraid we’re in for some rough times ahead!

___________________________

*It’s common to talk about science-based decision making in policy.  But here I decided it was more appropriate to use the idea of evidence-based decision making – reflecting the language and discussions that tend to occur in policy circles.  “Evidence-based decision-making” encompasses science, but is sufficiently broad to encompass the use of multiple sources of robust, quantfiable and verifiable information.